Battle of the bulge

A vibrator belt that works only on trimmed bodies. Skin infection. Ill-equipped clinics and untrained dieticians. Is it time to call the bluff on weight loss clinics? Paramita Ghosh and Mayank Tewari examine.

It is a cluttered façade. Hair straighteners, nail polish bottles and diet pills line the glass front of a weightloss clinic run from the basement of a residential colony in Delhi. “We have the Zeenat slimming system,” says the gym instructor who doubles up as receptionist. “You want a sitting? For cardio and gym, we have a package of Rs 3,100. If you don’t want cardio and gym, take the sitting. It is Rs 2,500 for 10-12 sessions.” The ‘sitting’ is a lie-in in the corner room of a beauty parlour inside the clinic. The bed serves as the massage and body waxing bunk at other times; the slimming consultant multi-tasks as the hair stylist.

The establishment is run without a doctor. The proprietor is the resident dietician. ‘Have fruits’ is his paid-for advice. “You will lose charbi (fat) — it could be 3 kilos, it could be five. Whatever it is, we make you happy. If you do gym too, it would cost you Rs 11,000 a month, but you would get results.” At every such clinic, any talk of health is left aside — for commerce.

Dr Shikha Sharma, a Delhi-based nutritionist, says 30 per cent of her clientele comprises those who have been disappointed by fat-busting firms. “They are calling it a con and are among my most difficult patients,” she says. The

Rs 30,000-40,000 package that most people sign up for is a big letdown. Some of the most common grouses is the lack of legal redressal or a provision for refund. There is an attempt to channel dissatisfaction elsewhere. “If angry customers raise a din, a beauty treatment for an equal amount is offered as settlement,” says Saroj Bala, former head of dietetics at AIIMS. For all the flash of gadgetry, a client who has turned up with weight gain is told to return home and lose fat before she can put on the vibrator belt at a clinic. “The logic beats me. If the client could lose weight on her own, why should she be paying big money at the clinic?”Bala says.

Who's eating my lunch?

Ill-trained dieticians do more harm than good, say most nutritionists. ‘Do not eat lunch’, ‘eat fruit’ and ‘drink liquids’ are the pillars of the special diet. Weight gain is a natural corollary of our lifestyle habits — low on exercise, high on junk. A dietician who does not keep an eye on this factor will only speak in tangent. “I drink wine occasionally, but the dietician had no clue whether that would interfere with my diet or whether it was a healthy antioxidant,” says Vikas Suri, a travelling businessman. They are also fuzzy about calorie intake, metabolism, how to measure the BMI (body mass index), or that the two sexes lose weight differently because of different fat-to-muscle ratios.

Clinical nutritionist Ishi Khosla says, “I try and first understand the client. What are their eating, exercising and socialising habits? How motivated are they towards losing weight? Once we understand the lifestyle, we make healthy interventions in the diet and suggest exercises. I do not promise any weight loss and expect people to exercise on their own.”

The starvation diet works in the beginning. Ronita Singh, a 30-year-old housewife in Kolkata, bought a package that promised the loss of 10 kg in 20 days. “For two weeks, I was on a health powder, was allowed to have only some food, and was asked to undergo vigorous weight lifting. It made me so weak that I fainted and was hospitalised for two weeks. I ended up with a damaged liver,” she says. The fallout of a misinformed diet can be immense: calcium loss, low vitality and damaged metabolism. After rapid weight loss, metabolism slows down. It is five times harder to keep off weight gain after that.

The shiny gyms that accompany most clinics attract men as much as women. Varun Rana of Gatbandhan Matrimonial, a marriage agency, says: “I tell my overweight Punjabi and Bania male clients that a 100-kg man will only get a 100-kg bride. If you want slim girls, there is no harm working out at a weightloss clinic.”

The interlocking of the health and beauty markets has created an illusion of choices, says sociologist Patricia Uberoi. Will weight loss enhance appearance or lead to fitness? “That’s the new debate,” she says. Weightloss clinics, part of the racket that creates new anxieties about the body beautiful, to quote Umberto Eco, is built on the tension between a beauty that is perishable and one that can be reproduced.

Rogue machines and their rogue operators are another part of the same story.

Magic pill and quick fixes

Dr Anoop Misra, head of diabetics and metabolism at Fortis Hospital, calls the bluff of the stimulator belts. “They cause involuntary movement of muscles, which leads to heightened blood pressure and causes urination. The loss of water with urine, coupled with the toning of muscles by the stimulator, gives the impression of an immediate weight loss.” The reduction happens at the point of temporary contraction. When the muscles relax, it’s back to square one.

Dr Misra has also come across cases where diuretics (drugs that make the body lose water) have been clandestinely administered. “Ditide and Lasix are two common diuretics that clinics push. These drugs are meant for people with high blood pressure or water accumulation — and not for water loss. The loss of water alone can cause one kg weight loss in two days.”

There are only two drugs that have been approved for weight loss. Sibutramine works by reducing the appetite, while Orlistat interferes with fat absorption in intestines. “But these drugs are not meant for all overweight people. They are meant for people with a BMI higher than 30. The BMI range for Indians is 18.5-23. Anyone with a BMI above 23 is overweight, while people with a BMI of 25 or more are obese. To prescribe the drugs to people with a lesser BMI would be dangerous.”

Ajay Kumar, a 47-year-old property dealer in Noida, weighed 105 kg at the time of joining a clinic. Today he weighs 15 kg more. “I developed a prolonged skin infection from the stimulator belts that were used on every client.” He did not take the clinic to court. But it’s about time.

With Manoj Sharma in Delhi, Rashmi Sharma in Kolkata and Rachel Lopez in Mumbai